D. Lee

G. Rinomhota

N. Sam-Agudu

U.C. Anaba

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A n n a l s o f G l o b a l H e a l t h , V O L . 8 3 , N O . 1 , 2 0 1 7 Women’s Health is Global Health e Issues Across the LifespanJ a n u a r y eF e b r u a r y 2 0 1 7 : 9 4 – 1 0 9105Jiao Tong University School Of Medicine, Shanghai, China, 5Hang-zhou First People’s Hospital, Hangzhou, ChinaBackground: Access to breast cancer screening in China isprimarily limited by the shortage of qualified radiologists in primaryhospitals. Automated Breast Ultrasound System(ABUS) is a poten-tial method to alleviate current shortages in accessible breast cancerscreening. This study aims to evaluate the effectiveness of ABUS bycomparing it with Hand Held Ultrasound(HHUS) andMammography(MAM).Methods: This study takes place at 3 cancer hospitals and 2 generalhospitals. Women aged 30-69, who visited breast surgeons, withoutvisible, suspicious signs of breast cancer and had signed InformedConsent Form were eligible for HHUS and ABUS, and womenolder than 40 also received MAM. All images were interpreted byqualified doctors based on Breast Imaging Reporting and DataSystem (BI-RADS). Categories 4-5 were considered to be “suspi-cious” lesions. The consistency rates and Kappa statistics were calcu-lated to assess the reliability of ABUS compared with HHUS orMAM in each age or hospital group. Participants were dividedinto four groups by the age of ten, and ABUS was compared withMAM in the older groups (>40 years old) only.Findings: By taking unilateral breast as the unit of analysis, wehave acquired 1734 results for HHUS and ABUS, and 1108 resultsfor MAM. The consistency rates in each age group between HHUSand ABUS were 95.37%, 95.97%, 96.07% and 92.78%, and theKappa values were 0.79, 0.88, 0.89 and 0.81, respectively; Theconsistency rates between MAM and ABUS were 92.12%,92.41% and 93.89%, and the Kappa values were 0.74, 0.77 and0.83 respectively. In the cancer hospitals, the consistency ratesbetween HHUS and ABUS or MAM were 95.61% and 93.33%,and the Kappa values were 0.87 and 0.81; while in the generalhospitals, the consistency rates were 95% and 90.14%, and theKappa values were lower ( 0.71 and 0.55).Interpretation: Reliability was observed when comparisons weremade between each age group. ABUS images can be collected bytechnicians and interpreted by qualified doctors. Considering theabsence of qualified radiologists, ABUS may play an importantrole in general and primary hospitals. Other clinical performanceindicators of ABUS, including sensitivity and specificity, need tobe further demonstrated.Source of Funding: Investigator Initiated Research Sponsored ByGE Healthcare.Abstract #: 1.026_WOMPrevalence of Teenage Pregnancy at Saint-Nicolas Hospitalin Saint-Marc, a Community Hospital in HaïtiE.F. Julceus1, O. Sainterant2, R. St-Jean2, N. Sohler3, K. Israel2;1Zanmi Lasante, Tabarre, Haiti, 2Zanmi Lasante, Port au Prince,Haiti, 3City College of New York, New York, USABackground: Teenage pregnancy is a significant public healthproblem. It affects 10% of births worldwide and has harmful healtheffects on mothers and newborns. Additionally, it is stigmatized inmany countries, resulting negative socioeconomic consequences.Several risk factors have been identified, however none of theprevious studies conducted in the Caribbean explored the role ofCarnival. Carnival is often thought to be conduit for unplannedsexual encounters. This study aimed to determine the proportionof teen pregnancy at Saint-Nicolas Hospital (HSN) broadly, andat the different points were the pregnant woman (PW) soughtcare as well as testing whether the proportion increased during thecarnival period.Methods: This cross sectional study included PW seen fromOctober 2013 to September 2014 in HSN for antenatal care,delivery and post abortion care. These women were classifiedaccording to the first service received. Teenage pregnancy wasdefined as pregnancy in a woman under 20 years. Data on theirlast menstrual period was used to determine the quarter in whichthe women became pregnant. The carnival period included Januaryto March. Data were extracted from the register, entered intoMicrosoft excel 2013, and analyzed using Epi Info TM 7 andSPSS 20. We report on proportion of all pregnancies involvingteenage pregnancies and used chi-square to test statistical signifi-cance of difference in proportions of teenage pregnancies by monthof conception and type of service.Findings: Among 5232 registered pregnancies, 12.82% involveda teen pregnancy. This prevalence was 10.54% among the 2391woman seen in the delivery service, 14.22% among the 2455 seenfor antenatal care, and 18.13% among the 386 seen for post abortioncare (p<0.0001). Based on the quarter when women became preg-nant, proportion of teen pregnancy varied from 13.34% to 14.84%during the carnival period (p¼0.97).Interpretation: The proportion of teenage pregnancy among allpregnant women seeking services in HSN is slightly higher thanthe global average. A larger proportion were teenage pregnanciesin the post abortion service than the other two, but there was noassociation with carnival period. Then, it is important to sensitizethe population about it throughout the year.Source of Funding: None.Abstract #: 1.027_WOMRates of Viral Suppression among HIV-positive Women inRural North-central NigeriaD. Lee1, G. Rinomhota2, U.C. Anaba3, N. Sam-Agudu4; 1Universityof Maryland, Baltimore, Baltimore, Maryland, USA, 2University ofMaryland Baltimore, Baltimore, USA, 3Instituition, Federal CapitalTerritory, Abuja, Nigeria, 4University of Maryland Baltimore, Balti-more, MD, USABackground: The effectiveness of antiretroviral drugs in preventionof mother-to-child transmission (PMTCT) and suppression of viralload (VL) is well-documented. In addition, viral suppression is inline with the 90-90-90 global strategy of HIV elimination. To deter-mine adherence and effectiveness of PMTCT treatment, we assessedVL in postpartum HIV-positive women enrolled in a large PMTCTimplementation research study in rural North-Central NigeriaMethods: Within this prospective cohort study, 497 HIV-positivepregnant women were enrolled from 20 Primary Healthcare Centers(PHCs). Viral load (VL) testing (blood test with lower limit of detec-tion of <20 copies/ml) was performed at 6 months post-partum. PerWomen’s Health is Global Health e Issues Across the Lifespan A n n a l s o f G l o b a l H e a l t h , V O L . 8 3 , N O . 1 , 2 0 1 7J a n u a r y eF e b r u a r y 2 0 1 7 : 9 4 – 1 0 9106WHO guidelines, women with VL <1,000 as suppressed/adherent,while those with VL of >1,000 copies/ml were classified as non-sup-pressed/treatment failure. Wilcoxon ranksum, Spearman’s correlationand Kruskal-Wallis were used to test for associations.Findings: Out of 497 enrolled women, 275 (55.3%) presented forVL testing and 234 (85.1%) had their samples collected. Out of 213(91.0%) available results, 171 (80.3%) were virally suppressed/adherent. ART regimen (EFV vs NVP vs PI) (p¼0.56), durationon ART (p¼0.43), employment status (p¼0.72), educational status(p¼0.15) were not determinants of suppression. For distance livedfrom PHC, there was a positive but weak correlation where VLwas higher with further distance lived (p¼0.08).Interpretation: While the target of 90% was not achieved,a substantial proportion of women (80%) were adherent to ART.Only distance lived from facility approached significance as a deter-minant of suppression/adherence. This is understandable as ruralareas often have difficult terrain, and residents are often economi-cally disadvantaged. Additionally, ART regimen did not makea difference in suppression rate, giving EFV vs NVP comparableefficacy in our study cohort. Approximately 20% of women failedtreatment; however they were not labeled “non-adherent” due tothe possibility of acquired resistance, which was not assessed inthis study. While this study demonstrates appreciable treatmentsuccess in a cohort of rural women, more robust studies are neededin Nigeria to determine factors associated with ART non-adherenceand non-suppression among PMTCT clients.Source of Funding: WHO INSPIRE MoMent Grant Funded byGlobal Affairs, Canada.Abstract #: 1.028_WOMNew Narratives in Global Health: Using Stories andStorytelling to Promote Family PlanningR. Limaye1, A. Ballard2, E. Futrell3, N. Ahmed2, S. Ohkubo2; 1JohnsHopkins Bloomberg School of Public Health, Baltimore, MD, USA,2Johns Hopkins Center for Communication Programs, Baltimore, USA,3Johns Hopkins Center for Communication Programs, Baltimore, USABackground: The use of stories and storytelling may providea powerful approach to sharing knowledge, and empirical evidenceillustrates that both approaches can impact global health outcomes.Stories and storytelling have the potential to spread knowledge byleveraging a traditional means of communication: the Humans ofNew York (HONY) initiative suggests that the power of a simpleimage and a few carefully-chosen words can influence individualknowledge, attitudes, beliefs, and behaviors. The Family PlanningVoices initiative aims to document, through photography and inter-views, the stories of individuals working to improve access to familyplanning around the world and share their experiences widely. Asthere has yet to be a systematic investigation that documents theimpact of a storytelling approach in family planning in lower- andmiddle-income countries, we sought to ascertain the impact of theFamily Planning Voices initiative.Methods: An online cross-sectional survey was distributed amongpractitioners working in family planning in lower- and middle-income countries through various global health list servs. Inclusioncriteria included practitioners working in family planning thatwere aware of the initiative. Outcomes of interest included theeffects of the initiative on knowledge and attitudes, as well as diffu-sion of information and knowledge application, on family planningglobal health practitioners.Findings: Approximately 71% of the 355 respondents indicatedthat the initiative provided them with family planning informationthat was new to them. In addition, 60% of respondents indicatedthat the initiative provided them with family planning informationthat changed their attitudes toward family planning access andneeds, while 87% indicated that they talked to a colleague abouta story. Approximately 84% of respondents indicated that the initia-tive prompted them to incorporate new family planning knowledgeinto their work.Interpretation: Results indicate that the initiative positivelyimpacted knowledge and attitudes toward family planning access,and encouraged knowledge sharing of best practices and discussionabout family planning needs within a global health context amongfamily planning practitioners. In this presentation, the feasibilityof such an approach to impact global health behaviors will be dis-cussed, as will the process used to create and curate such storiesfor maximum impact.Source of Funding: United States Agency for InternationalDevelopment.Abstract #: 1.029_WOMGlobal Advocacy for Women: Impact of Simulation-basedTrainingN. Lowy, M. Rota; Wagner College, Staten Island, NY, USAProgram/Project Purpose: Latin America is plagued by highmaternal and infant mortality rates, often attributed to limitedmaternal healthcare provided by traditional birth attendants, or coma-dronas. This led to our development of a simulation-based culturallysensitive educational program specifically for these providers.Structure/Method/Design: A simulation-based culturally-sensi-tive training program was offered to comadronas in Guatemala.The training began with an oral presentation (English, Spanish,and Mayan), emphasizing key points of the normal birthing processand the management of complications such as post-partum hemor-rhage (PPH). Visual aids and simulation manikins afforded hands-on opportunities to practice key points. Pre- and post-trainingsurveys were distributed to comadronas reflecting on knowledge,opinions of birthing practices, and ability to prevent and managecomplications. The surveys consisted of twenty-five questionsdivided into four sections reflecting on: demographics and currentbirthing practices, medical knowledge, opinions on the handlingof complicated deliveries, and feedback on the learning process.Outcome & Evaluation: PA faculty and students piloted a simula-tion-based culturally-sensitive training program with two groups ofcomadronas in two rural locations of Guatemala.The results indicated that the knowledge of the comadronasimproved from pre- to post-training surveys regardless of formaleducation, language, or age. Improvements per question rangedfrom 4-54%. Significant improvements were noted with specific

Rates of Viral Suppression among HIV-positive Women in Rural North-central Nigeria

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Rates of Viral Suppression among HIV-positive Women in Rural North-central Nigeria

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